Health Reform WK-EDGE Spousal impoverishment provision extended for home and community-based services
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Wednesday, February 26, 2020

Spousal impoverishment provision extended for home and community-based services

By Rebecca Mayo, J.D.

CMS has issued an informational bulletin to notify State Medicaid agencies that the ACA’s spousal impoverishment provision has been extended.

State Medicaid agencies have been advised that the recently enacted Further Consolidated Appropriations Act, 2020 has granted a fourth temporary extension of the ACA’s spousal impoverishment-related provision. The temporary extension requires states to continue applying the spousal impoverishment rules through May 22, 2020, and makes changes to how states may apply income and resource disregards (CMCS Informational Bulletin, February 10, 2020).

Extension. On December 20, 2019 the Further Consolidated Appropriations Act, 2020 was enacted. The Act modifies section 2404 of the Patient Protection and Affordable Care Act (ACA) to require that state Medicaid agencies apply the spousal impoverishment rules to married applicants and beneficiaries eligible for home and community-based services (HCBS) through May 22, 2020. States should continue to follow the CMS Guidance titled "Affordable Care Act’s Amendments to the Spousal Impoverishment Statute," which relates to the application of the ACA’s spousal impoverishment-related provisions so long as section 2404 of the ACA is in effect.

In addition to granting the temporary extension, the Act also made changes to how states may apply income and resource disregards to certain individuals eligible for HCBS. Further guidance on this will be provided soon, according to CMS. CMS also indicated that should the spousal impoverishment provision expire in the future, states can refer to the CMCS informational bulletin titled "Sunset of Section 2404 of the Affordable Care Act, Relating to the Spousal Impoverishment Rules for Certain Home and Community-Based Services Applicants and Recipients."

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